Stop The Bait-and-Switch on Annual Limits

The AP is reporting, via Jon Walker at FireDogLake, that Senator Reid has gutted one of the most important consumer protections in the HCR bill, the ban on annual limits.

The fact that this language has found its way back in the bill despite promises on the part of the Democratic leadership that protecting consumers of health care (and those who need it most BTW) was priority number one, is an especially large outrage among a series of outrages.

Here’s the language the HELP committee’s bill had in it regarding limits:

SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
`(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish lifetime or annual limits on the dollar value of benefits for any participant or beneficiary.
`(b) Preventing Fraud and Abuse- This section shall not apply until the date on which the Secretary certifies that enacting this section will not result in undue proliferation of fraud and abuse, especially with regard to durable medical equipment.No equivocation there. Clear and to the point.

Here’s the language that is now in the HCR package:

SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
`(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish-
`(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
`(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary.
`(b) Per Beneficiary Limits- Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage that is not required to provide essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act from placing annual or lifetime per beneficiary limits on specific covered benefits to the extent that such limits are otherwise permitted under Federal or State law.That one little word, unreasonable, is pointed out by me for obvious reasons. That one word is the loophole that we KNOW insurance companies will use as if it’s a a black hole into which billions of our dollars will disappear.

We need to stop this bait and switch NOW.

Please call Senator Schumer and Congressman Rangel now and insist that we go back to the HELP committee’s language:

Ensures consumer protections in the insurance market. Insurance companies will no longer be able to place lifetime limits on the coverage they provide, use of annual limits will be restricted, and they will not be able to arbitrarily drop coverage.In this case, they replaced the word “unreasonable” with “restricted.”

Just one little word will mean billions in profits to the Health Insurance Companies, and it seems that there are many in DC who are more than willing to make that happen. That money will come out of the wallets of citizens who need protection the most.